Search

Despite international guidelines, optimal delivery models of late effects (LE) services for HSCT patients are unclear from the clinical, organizational and economic viewpoints. To scope current LE service delivery models within the UK NHS (National Health Service), in 2014, we surveyed the 27 adult allogeneic HSCT centres using a 30-question online tool, achieving a 100% response rate. Most LE services were led and delivered by senior physicians (>80% centres). Follow-up was usually provided in a dedicated allograft or LE clinic for the first year (>90% centres), but thereafter attrition meant that only ~50% of patients were followed after 5 years. Most centres (69%) had a standard operating procedure for long-term monitoring but access to a LE Multi-Disciplinary Team was rare (19% centres). Access to medical specialities necessary for LE management was good, but specialist interest in long-term HSCT complications was uncommon. Some screening (endocrinopathy, cardiovascular) was near universal, but other areas were more limited (mammography, cervical smears). Funding of extra staff and investigations were the most commonly perceived barriers to implementation of LE services. This survey shows variation in the long-term follow-up of allogeneic HSCT survivors within the UK NHS and further work is warranted to optimize effective, sustainable and affordable models of LE service delivery among this group.

ABSTRACTWe examined potable water in Los Angeles, California, as a possible source of infection in AIDS and non-AIDS patients. Nontuberculous mycobacteria were recovered from 12 (92%) of 13 reservoirs, 45 (82%) of 55 homes, 31 (100%) of 31 commercial buildings, and 15 (100%) of 15 hospitals. Large-restriction-fragment (LRF) pattern analyses were done with AseI. The LRF patterns of Mycobacterium aviumisolates recovered from potable water in three homes, two commercial buildings, one reservoir, and eight hospitals had varying degrees of relatedness to 19 clinical isolates recovered from 17 patients. The high number of M. aviumisolates recovered from hospital water and their close relationship with clinical isolates suggests the potential threat of nosocomial spread. This study supports the possibility that potable water is a source for the acquisition ofM. aviuminfections.

The geology and geochemistry of the Senator antimony deposit in western Turkey is described. Mineralization in the Senator Mine area occurs within the Neogene, which comprises a sequence of siliceous and carbonatic rocks closely related to late Tertiary and early Quaternary volcanic activity. The Neogene rests unconformably on Permo-Carboniferous sediments. The mineralized orebodies take the form of fractured conical-shaped pipe-like zones or vents and are generally emplaced along the contact between the Neogene and the Palaeozoic. These mineralized vents seldom exceed 50 metres in diameter and 20 metres in depth. Mineralization is almost entirely constituted of oxides (stibiconite, scorodite, dussertite) with lesser amounts of amorphous sulphide (metastibnite). Quartz, barite, pyrophyllite, muscovite, cristobalite and a lead compound (composition Pb5O4SO4) are associated with the ore. The geochemistry of the Senator main orebody is characterized by the lack of correlation, random distribution and concentrations of Sb, As, Pb, Zn, Fe and Cu. It was also found that precious metal concentrations were insignificant. The comparison between the geochemistry of the Senator deposit and the precipitates from the Illica hot spring have shown a remarkable similarity in element assemblage and concentrations. Finally an idealized geological evolution and theory of mineralization for the Senator Mine ore are discussed.

Simulation can reduce some of the hardware demands of telerobot systems but, to date, a heavy commitment to computer hardware has been required to produce a real-time response. Parallel processing of a balanced division of the Newton–Euler formulation on transputers is used to perform real-time dynamic simulation for a 7 d.o.f. robot. Comparative times for the transputer and other parallel processors are also given. Practical interfaces are derived for robot hardware, other features of the practical system which are developed include data storage and transferral strategies and also a graphical interface to the user on a PC displaying real-time force and position information. Approaches to the practical difficulties of identification and real-time simulation of complex friction effects are also examined.

Identification of mycobacteria through conventional microbiological methods is cumbersome and time-consuming. Recently we have developed a novel bacterial identification method to accurately and rapidly identify different mycobacteria directly from water and clinical isolates. The method utilizes the PCR to amplify a portion of the small subunit rRNA from mycobacteria. The 5' PCR primer has a fluorescent label to allow detection of the amplified product. The PCR product is digested with restriction endonucleases, and an automated DNA sequencer is employed to determine the size of the labeled restriction fragments. Since the PCR product is labeled only at the 5' end, the analysis identifies only the restriction fragment proximal to the 5' end. Each mycobacterial species has a unique 5' restriction fragment length for each specific endonuclease. However, frequently the 5' restriction fragments from different species have similar or identical lengths for a given endonuclease. A set of judiciously chosen restriction enzymes produces a unique set of fragments for each species, providing us with an identification signature. Using this method, we produced a library of 5' restriction fragment sizes corresponding to different clinically important mycobacteria. We have characterized mycobacterial isolates which had been previously identified by biochemical test and/or nucleic acid probes. An analysis of these data demonstrates that this protocol is effective in identifying 13 different mycobacterial species accurately. This protocol has the potential of rapidly (less than 36 h) identifying mycobacterial species directly from clinical specimens. In addition, this protocol is accurate, sensitive, and capable of identifying multiple organisms in a single sample.